Teresa Matias, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-005449 Issued in IL

Practice address

2674 Washington St
Waukegan, IL 60085-4917

Phone

(847) 336-8089

Fax

(847) 336-8079

NPI assigned

Jun 1, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 7

Other names 1

• Teresa Ewing Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: teresa.matias.p7@direct.athleticoltd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sports Physical Therapy & Rehab Specialists, S.C.

  dba Athletico Physical Therapy

  • Physical Therapist
  • Kenosha, WI
  • NPI 1326150624
  NPD (past)
• Sports Physical Therapy & Rehabilitation Specialists S.C.

  dba Athletico Physical Therapy

  • Clinic/Center
  • Mukwonago, WI
  • NPI 1174187975

  Physical Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1598991879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2674 WASHINGTON ST",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600854917",
            "telephone_number": "847-336-8089",
            "fax_number": "847-336-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATIAS",
        "first_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2515-024",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-005449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "539320005",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01119496",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "859400055",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IL6697002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IL6237007",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "205086005",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IL6238007",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "EWING",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Antoinette Massari, RN
• Hayley Diana Massey
• Arabella Mata
• Daniel Philip Mateling, PA-C
• Elizabeth Mathews
• Nathalie Matjusenko-Yasen
• Allison Rose Matuszewski
• Stacy Melanie Matute
• Cintia A Max
• Brianna Marie May

• Physical Therapist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.